The present invention relates to medical fastening devices and methods for use in minimally invasive surgery.
Minimally invasive surgery has been used in many formerly complex medical procedures, such as gall bladder removal, urological and reproductive operations, valve repair and replacement and by-pass operations. Minimally invasive surgery involves inserting tools into a patient through a natural opening or small incision in the body. The surgical tools are then manipulated from outside the patient. This approach to surgery has a number of advantages, including, inter alia, that it is generally less traumatic, smaller incisions, if any, are needed, and the patient has less post-operative pain and a shorter recovery time.
Minimally invasive surgery requires tools that a surgeon can trust. In particular, a surgeon needs reliable indication of when and how a procedure is completed. Ideally, tactile, audible and visual confirmation of operation is available to surgeons.
A resectioning procedure will be used in this disclosure as a specific example of a technique requiring a fastening device, such as the present invention, and a procedure suitable for minimally invasive surgery. There is no intention to limit the present disclosure to resectioning or endoscopic surgery in particular. The fastening device could, for example, be used in laproscopic surgical procedures. A resectioning procedure involves excising a portion of an organ, fastening the surrounding tissue together to close up the hole created by the excision, and removing the excess tissue. Various conventional devices and procedures are available for resectioning lesions in tubular organs.
A Full Thickness Resectioning Device (FTRD) comprises a fixed housing, a removable cartridge body containing staples, a large diameter rotary shaft slidable within the removable cartridge body, the staple drivers having a staple end adjacent to the staples and a driven end and an actuator disposed in the fixed housing, the actuator moving the staple drivers to push the staples against an anvil portion of the FTRD when in the attached configuration. The standard fastening device used in the FTRD has more custom-machined parts than the present invention, increasing its cost. Additionally, the rotary shaft used to control the fastener is relatively stiff, preventing free passage of the FTRD, particularly past the pelvic brim.
The terms xe2x80x9cfastener,xe2x80x9d xe2x80x9csuturexe2x80x9d and xe2x80x9cstaplexe2x80x9d are used in this disclosure as understood by persons skilled in the art. Those skilled in the art will understand that xe2x80x9csuturesxe2x80x9d and xe2x80x9cstaplesxe2x80x9d are examples of xe2x80x9cfastenersxe2x80x9d and that the term xe2x80x9cfastenerxe2x80x9d may include other elements.
The term xe2x80x9cproximalxe2x80x9d refers to an element of the apparatus located closer to the outside of the patient""s body or the user of the apparatus or device. xe2x80x9cDistalxe2x80x9d refers to an element or part of the device located farther inside the patient""s body or from the user of the apparatus or device.
A method of firing fasteners by removing a wire or shutter from between springs and the fasteners, which sequentially releases each spring is disclosed.
A minimally invasive medical fastening device comprising spring loaded fasteners fired, or deployed, by sequentially releasing a shutter is also disclosed.